Congenital Pseudoarthrosis of the Tibia
- the most common cause of anterolateral bowing.
- It is often accompanied by neurofibromatosis (50%-but only 10% of patients with neurofibromatosis have this disorder).
- Classification (Boyd) is based on bowing and the presence of cystic changes, sclerosis, or dysplasia and cystic changes are most common.
Tibial Pseudoarthrosis Treatment
- total contact brace to protect from fractures
- intramedullary fixation with excision of hamartomatous tissue, and autogenous bone grafting (osteosynthesis) for nonhealing fractures.
- Vascularized fibular graft or Ilizarov methods should be considered if bracing fails.
- Osteotomies and electrical stimulation alone are contraindicated.
- Amputation (Syme's) and prosthetic fitting are indicated after two or three failed surgical attempts.
- Murray HH, CORR 1982;166:14
- Crossett LS, CORR 1989;245:16